Mental–Physical Multimorbidity in Youth: Associations with Individual, Family, and Health Service Use Outcomes

  • M. A. FerroEmail author
  • E. L. Lipman
  • R. J. Van Lieshout
  • M. H. Boyle
  • J. W. Gorter
  • H. L. MacMillan
  • A. Gonzalez
  • K. Georgiades
Original Article


Prevalence, correlates, and outcomes of youth with comorbid mental and physical conditions (i.e., multimorbidity) were examined in this cross-sectional study. Participants were 92 youth (14.5 years [SD 2.7]; 69.6% female) and their parents. Mental disorder was assessed using structured interviews and physical health using a standardized questionnaire. Twenty-five percent of youth had multimorbidity and no child or parent demographic or health characteristics were correlated with multimorbidity. Youth with multimorbidity reported similar quality of life and better family functioning [B = − 4.80 (− 8.77, − 0.83)] compared to youth with mental disorder only (i.e., non-multimorbid). Youth with multimorbidity had lower odds of receiving inpatient services [OR = 0.20 (0.05, 0.85)] and shorter stays in hospital for their mental health [OR = 0.74 (0.57, 0.91)] over the past year. Family functioning was found to mediate the association between youth multimorbidity and length of stay [αβ = 0.14 (0.01, 0.27)]. Findings reinforce the need for family-centered youth mental health care.


Adolescent Child Chronic disease Mental disorders Quality of life 



The authors gratefully acknowledge the children, parents, and health professionals and their staff without whose participation, this study would not have been possible. We especially thank Jessica Zelman for managing the study and Felice Bontempo for reviewing a previous iteration of this manuscript. At the time of the study, MAF was supported by a Research Early Career Award from Hamilton Health Sciences. MAF currently holds the Canada Research Chair in Youth Mental Health; MHB holds the Canada Research Chair in the Social Determinants of Child Health; KG holds the Dan Offord Chair in Child Studies; JWG holds the Scotiabank Chair in Child Health Research; AG is supported by a Canadian Institutes for Health Research New Investigator Award; HLM holds the Chedoke Chair in Child Psychiatry; and, RJV holds the Canada Research Chair in the Perinatal Programming of Mental Disorders and Albert Einstein/Irving Zucker Chair in Neuroscience.


This study was funded by Hamilton Health Sciences (NIF-14363).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Public Health and Health SystemsUniversity of WaterlooWaterlooCanada
  2. 2.Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonCanada
  3. 3.Department of PediatricsMcMaster UniversityHamiltonCanada

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